Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $138.04	Professional		$112.20	$112.20	$138.04
CareFirst Facility/Professional Professional Modifier Low / Median / High Price $338.84 / $338.84 / $338.84	Professional		$338.84	$338.84	$338.84
Cigna Facility/Professional Facility Modifier Low / Median / High Price $112.20 / $112.20 / $112.20	Facility		$112.20	$112.20	$112.20
Cigna Facility/Professional Professional Modifier Low / Median / High Price $112.20 / $112.20 / $131.83	Professional		$112.20	$112.20	$131.83
Kaiser Permanente Facility/Professional Professional Modifier Low / Median / High Price $131.83 / $186.21 / $288.40	Professional		$131.83	$186.21	$288.40
United Facility/Professional Facility Modifier Low / Median / High Price $316.23 / $316.23 / $316.23	Facility		$316.23	$316.23	$316.23
United Facility/Professional Professional Modifier Low / Median / High Price $125.89 / $316.23 / $398.11	Professional		$125.89	$316.23	$398.11
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $151.36 / $173.78 / $204.17	Professional		$151.36	$173.78	$204.17